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Beware of Comprehensive Health Care Reform

I was listening to National Public Radio's morning "news" Monday on the way to work, during which the newsperson read the apparently "factual" statement that the United States is the only developed country that does not provide "comprehensive" health care coverage.

Perhaps only those of us who are highly trained ideological vigilantes would leap to attention on the use of the word comprehensive. To most people, the word comprehensive sounds good. Of course, those who opposed "comprehensive immigration reform" a few seasons ago might have started twitching on hearing the word applied to health care reform.

Comprehensive, as the dictionary defines it, means "including all or everything." It is very similar in meaning to the definition of total, which the dictionary defines as "complete, thorough." If something includes everything, it is complete.

Of course, it is not surprising that NPR uses the White House talking-point word "comprehensive" rather than its synonym "total," because total health care coverage easily might sound like totalitarian health care coverage. And by the way, the dictionary defines totalitarian as "having and exercising complete political power and control." Note that pesky word complete -- a synonym for comprehensive -- in the definition of totalitarian.

And of course, the word "reform" (as in the phrase "comprehensive health care reform"), which is defined as "to improve by alteration, correction of error or removal of defects; put in better form" is itself subjective and assumes several facts not in evidence -- most pointedly that a reform will "improve" or "correct" an "error" or "defect."

The foregoing is not intended as merely overdrawn semantics. Words convey concepts, which shape public thoughts, which lead to public support for legislation, which may change the way we live our lives -- and meet our deaths.

So to provide comprehensive health care reform suggests that defects and errors in our current limited health care system would be improved and corrected with complete health care services for all. What could be wrong with having new, improved and complete stuff for all? After all, for generations we have heard on television similar words: "Improved Tiger Flakes provide complete calcium and vitamin needs for your children's health."

But sometimes, partially hidden meanings in persuasive-sounding words may be unwelcome truths that advocates don't want the public to think about.

Because, when you think about it, it also could be said of America that we do not have a "comprehensive food-provision system" or a "comprehensive clothing-provision system" or a "comprehensive housing system" or a "comprehensive economic-planning system" or a "comprehensive job-providing system."

In fact, of course, those comprehensive systems are only available in countries that comprehensively control human lives and actions. How else can the government assure "complete" things if it doesn't control things "completely" -- or "totally"?

We have seen many examples in this sad world of what the citizens get when their governments provide comprehensive or total goods and services. Freedom of action -- or inaction -- is possessed "comprehensively" by the government, while whatever the government gives the public "comprehends" the total that the public gets of a good or service. As between two parties, something comprehensively possessed by one is, by definition, completely not possessed by the other.

The current health care proposal is a ripe example. In a recent op-ed defending the administration's health care proposal, Sen. Ted Kennedy and Bob Shrum argued: "We also need to move from a system that rewards doctors for the sheer volume of tests and treatments they prescribe to one that rewards quality and positive outcomes. For example, in Medicare today, 18 percent of patients discharged from a hospital are readmitted within 30 days -- at a cost of more than $15 billion in 2005. Most of these readmissions are unnecessary, but we don't reward hospitals and doctors for preventing them. By changing that, we'll save billions of dollars while improving the quality of care for patients."

But as Bill Kristol in The Weekly Standard brilliantly pointed out about the idea that the readmissions aren't needed and that we don't reward the prevention of them: "The most important implication of the Kennedy-Shrum claim ... is this: The government is going to decide -- ahead of time, obviously, since deciding after the fact wouldn't save any money; and based on certain general criteria, since the government isn't going to review each individual case -- what kinds of hospital readmissions for the elderly are 'unnecessary' and what kinds aren't. And it's going to set up a system 'to reward hospitals and doctors for preventing' the unnecessary ones. That is, the government will reward hospitals and doctors for denying care they now provide, care the government will now deem 'unnecessary.'"

Of course, we have the advantage that the Kennedy-Shrum article was published for all to read. The actual legislation doubtlessly will not be available for review before it is voted on.

All we can know for sure is that the Democrats' comprehensive health care reform legislation will empower bureaucrats comprehensively to make all decisions, vital and trivial, regarding your health care coverage -- or non-coverage. The comprehensive power of the federal government will completely and totally extinguish your control over your health treatment.

The price of freedom is that you will not be taken care of comprehensively. The price of being taken care of comprehensively is that you won't be free. You pays your price and you takes your choice. Down with Comprehensiveness! Up the Revolution!

Tony Blankley is executive vice president of Edelman public relations in Washington.

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